C-section birth: An enhanced recovery?

How long did you stay in hospital for after your c-section? It’s varied for me, hugely in fact. From a lengthy first stay to an extremely short visit And I’ve come to wonder whether enhanced recovery really does work at all.

My first was 11 years ago and although it was classed as an emergency it turned out to really be nothing of the sort. Still,l my eldest was born in the early hours of the Tuesday morning, and we were told we’d be staying at least until Saturday. That’s five days, six if you count the previous day when I’d been admitted to be induced. We managed to get away on the Thursday, but only after convincing the doctor I’d be well looked after.

My second c-section was an earth shattering category one emergency, with my son being ripped from my body at lightening speed whilst I was forced under general anaesthetic. I woke up sore and confused. Numb arms. Itching body. No recollection of what had happened. This was in the early evening on the Sunday, and I was sent home on the Tuesday late afternoon. That makes it about two days. I was discharged with no pain relief and very much against my better judgement; in fact I asked to stay and was told not to be silly.

My third c-section was planned. It was calm. It was quite beautiful, in as much as it can be when someone is rummaging inside your body to find a baby. I was told that if I could get up and about within 8 hours post op (and empty my bladder twice) I would be allowed to go home the next morning. And I did. If I’d have been able to skip with joy, I would have. I was delighted to be going home!

My fourth c-section has been well documented here. The pregnancy was hugely stressful and I spent much of the last three months in hospital, having growth scans, doppler scans and being hooked up to the CTG. An IUGR pregnancy is no laughing matter. And when it came to mode of delivery, a VBAC was out of the question, so what we discussed instead was plans for my ‘elective’ c-section. I was told that I’d be given energy drinks and would take part in the hospitals enhanced recovery program.

Nobody I spoke to had heard of this program, so I quizzed the doctor and was told that they believed my recovery would be much better at home. So I’d drink energy drinks to speed up the process and I would be sent home the next day, no matter what. At this point, we were still unsure of how well Elsie would even be, but the plan was definite. If she was staying, I was not.

When it came to the pre-op, I was given two bottles to drink- one to take the night before, and one to take the morning of my op. I was told that I was going home. This was not a negotiable matter.

I was admitted the night before my section as I’d had repeated reduced movements and the hospital wanted to keep an eye on Elsie. And though she was born on her scheduled date, we very nearly found ourselves in another emergency situation a couple of times. Elsie’s first night in the world was not an easy one. She did not feed at all, and her temperature was very unstable. She was on 15 minute observations and I was on half hourly observations. After 12 hours we went to half hourly for her and hourly for me. The next morning I was taken from the enhanced recovery ward to the post natal ward and told I may not be going home after all, as Elsie was still yet to feed. This clearly was a problem.

On the postnatal ward, I finally managed to get something to eat (a good 18 hours since my last meal) and tried desperately to feed Elsie. Her blood sugar and temperature was now fine, but she still was not feeding. And me?

I was a mess. Exhausted. I’d been nil by mouth for most of the day prior to my section, and had eaten only a sandwich afterwards. That day I had only eaten toast around 12pm and had very little to drink. How I was expected to breastfeed a reluctant baby, I’ll never know. I was also in a terrifying amount of pain. My back had seized up, meaning that walking was impossible, and my scar was on fire. I couldn’t lift my baby, and yet on the postnatal ward I had nobody to help me.

And then they sent me home.

Just like that.

Oh, this is baby number four. You know what you’re doing!

You know what? I didn’t. I was terrified. And in pain. And exhausted. And confused.

And yet, I’d enrolled on an enhanced recovery program. I was supposed to be ready. Surely I wanted to go home, to see my other children? Yes, yes of course I wanted to see them. But I didn’t want them to see me. Not like that.

I spent the first night at home sitting upright in a chair because it was too painful to climb the stairs to bed. I waited all night for everyone to get up so that I could have help going to the bathroom and getting more painkillers. I sobbed. I was in so much pain, I wanted to disappear. I held my baby, and I sobbed.

Elsie continued to refuse to feed. We never saw her eyes open. She didn’t cry. Her lips were dry and cracked. Her skin was grey. Her body was floppy. She was literally fading away before my eyes and I could do nothing aside from express, syringe feed, and hope. Hope that she would wake up. Hope that being admitted to hospital for tube feeding would not happen. Hope that I would make it through another long and lonely night filled with pain.

22 Comments

my first section was an emergency (nearly 15 years ago) I was in hospital 7 days and resented every minute of it.

With Joshua (nearly 5 years ago) with so many complications in the pregnancy i was given no choice but to have an elective section and spent months brooding over it, resenting it even however I can’t believe just how amazing his birth was.

It was calm and quite and i was allowed everything i wanted from immediate skin to skin (no wiping) no taking him from me nothing i was breastfeeding within 15 minutes of him arriving and he never left me till in the recovery room … it was the most beautiful experience … i just hope to god that i have the same again this timeJaime Oliver recently posted..Five Things They Didn’t Tell Me About Pregnancy

Oh your second section sounds amazing! I wanted the same with bella but her temperature was too low. And due to Elsie’s issues I couldn’t do it then either. Have you seen Jenny the M’s skin to skin in theatre campaign? She has a FB page which I think you’d love x x

I’m booked for an elective section at the end of November and the prospect of being discharged with 24-48 hours terrifies me. With my first I was in five days, my second was three days however was then readmitted due to a bleed, infection and low blood count so I’m not in any hurry to rush out the door this timePolka Dot Family recently posted..The one with the contractions, water infection and a wake up call

I think that unless your hospital has told you about the enhanced recovery program, you can expect to stay a little longer than me. With bella, it was fine and I was ready to go home. But it all depends on each individual circumstance. Talk to your doctor, not all hospitals believe it is a good idea x x

This is just horrific! I have never heard of an enhanced recovery…Sounds more to me like they just want the bed….They have to take each person as they come and not make judgements on people before they have even had the baby….
I have had 2 c-sections and was never rushed…In fact they pressured me to stay in longer as my eldest wasn’t feeding well but that was 13 years ago….Kim Carberry recently posted..Pumpkin Carving….

I think enhanced recovery is all well and good when it’s a straightforward delivery of a low risk pregnancy. You were done a huge injustice – there’s no way you should have been sent home, enhanced recovery or not!Another Bun recently posted..Soon You Will Be Three

I think, had the pain not been as intense this time around, emotionally I was still not ready to go home. It was quite terrifying and I would like to see changes made that take into consideration individual situations. I am only now realising how much emotional damage my last pregnancy and birth has done! x x

Oh my God that sounds horrendous 🙁 when I saw the title I thought it was going to be some kind of extra layer of care they were offering to you. This just sounds like a means of rushing people out the door. I guess I had the “classic” care. I stayed 2 nights and 3 days and was glad to be home!

I think an extra night would have been a good idea for us. In priniciple I agree with the enhanced recovery because it makes sense to speed up the process to get you home, especially as your recovery is likely to be a lot better at home. But it needs to be considered case by case, and in our case we were not ready to go. Glad you stayed just long enough x x

Oh God, you have really had a rough time with c-sections. I had an emergency section on a Tuesday and was discharged four days later, the toughest part for me was leaving my baby in the special care unit. I was given a prescription for a week of pain killers, but told my doctor could prescribe more if needed. Despite the fact i hate taking medication of painkillers, I did need the week’s prescription and a few panadol after that. They really should not have let you out so quick xFiona @adventure_seek recently posted..Keeping the red rash under control

Oh yes my sections have not been all that great! Oh bless you having to leave your baby behind, it must be so so hard to do. I really hope that they find a better middle ground with regards to discharging women, enhanced recovery really didn’t work for me x

Oh my goodness Susanne, there was nothing about this recovery that was enhanced – that implies it is better, an improvement on what has gone before. A c-section is major abdominal surgery and I don’t think that they would offer this recovery to anyone recovering from any other abdominal surgery I’m sure it does work for some people but your pregnancy and Elsie’s feeding issues should have been a red flag for you needing to stay.Pippa Ainsworth recently posted..Win a Pair of Tickets to The Spirit of Christmas Fair

Oh my goodness reading this has just made me cry. I think that everyone should be taken on a case by case basis. Some people may be ready to go home, but others, like yourself were clearly not. No matter how many children you have had you were unwell you should have been looked after. I had an emergency c-section with my 2 year old. I was admitted on the friday, I had the c-section early hours of sunday morning and I was home monday night. I wanted to go home and I felt well enough, after emptying my bladder and doing the usual checks. Had I have not felt well I would have wanted to stay longer. Sometimes these things just don’t work and honestly I don’t think it would work for me either. There’s too much pressure to be well because you are suppose to be.The L’s Mum recently posted..5 Things you shouldn’t scrimp on when you have a family

Yes there is too much pressure. And knowing that I was supposed to be out soon really didn’t help with the panic and anxiety when Elsie wouldn’t feed either. It really wasn’t a great situation. Thanks for your lovely comment x x

I’m really shocked at the hospital’s enhanced recovery programme. It sounds really badly managed the whole way through- e.g. telling you from the outset you would definitely be going home even if your little one had to stay. That’s counter-intuitive. Your 3rd c-section sounds so calm and lovely though. I never had a section, but this this is a really good article with lots of experience and advice for anyone about to go through it x

I was able to go home the day after my first (planned) section (first baby) and was fine and happy to. I then wanted to do the same for the next planned section and got told no way José! hospital policy of a minimum 48 hours regardless of weather you are piddling and walking or not! I even said I knew they were packed to the rafters and probably needed that bed, but still wasn’t allowed to go home. Two different hospitals 12 miles apart, crazy how things differ. The first wasn’t even an enhanced recovery or anything, no energy drinks or anything!Lauren | Belle du Brighton recently posted..A Rambling we will go… Slindon Bottom!

How horrible that you had to go through that. I recall a similar situation with my 2nd baby – sent home same day in a wheelchair (well, I was in the chair until they tipped me into the car – then I was REALLY stuffed) and completely helpless during those first few nights, waiting for my husband to fetch more painkillers or help me to the bathroom. I will always be angry with the hospital for that. Why would you send someone home who couldn’t walk?!Karen Hannah recently posted..Gadget Guru: Dear Ski Diary…

Oh, my God! I know it sounds strange, but I can’t make up my mind whether it feels worse that you had such varied experiences. The shock of being treated so callously with your fourth section when you’d had such an easier experience earlier. Where these all in the same hospital?

It is incredible the way that women are treated so differently after major abdominal surgery purely because they are mothers. (At least, that’s what seems to be happening to me.) My wife had a planned section three years ago after her waters had broken four weeks early (we’re still not sure why) and he couldn’t be turned out of the breech position. The section went OK-ish, and she was kept in two nights: one with me there in a room full of staff monitoring her and trying to take bloods from poor little J-Bone, who screamed and wriggled and was a pin-cushion within hours; the second without me, on her own in the ward with J screaming with starvation as he wasn’t feeding properly, absolutely nightmarish for her. She was dying to get home, but we were back within days as his weight was dropping, as he wasn’t getting enough from the breast.

(Sorry, that was longer than I meant it to be..)

We’ve another babber on the way in March and are almost certainly going to request a second section. I’m interested that you’ve had four sections, as we’ve got the impression that the risk rises hugely after two. What kind of advice were you given?

Thanks so much for your comment. The first two sections were at the same hospital, the second two were also at the same hospital, but not the same as the first. There was only 2.5 years between the second two but the care overall was so different this time. I actually did not want a section 4th time around and had the support of my consultant for a trial of labour, depending on the results of scheduled growth scans. Unfortunately Elsie was growth restricted so another section was the only safe way to deliver her. I was told that there are increased risks with each c-section but I have been lucky enough to heal really well after each one and have only minimal scar tissue. Its not always the case for every woman though but they cannot tell you how many babies you are ‘allowed’ to have. It was suggested to me that I be sterilised during my c-section but sadly this was suggested merely seconds after being told my baby was growth restricted, at extreme risk of stillbirth, and would need to be born early. So I declined!

I hope all goes well for you both, do keep in touch and let me know how it goes x x

I am hearing more and more about this enhanced recovery program. West Sussex NHS that Caesarean sections will normally be in for up to 3 days. My midwife assured me that this would be the time scale unless I wanted to get home. But when I went to hospital to discuss my c section I was told I should be discharged in 24 hours 48 if I really felt the need to stay. I’ve had several friends who have had catheters removed before they had had the chance to stay up and we’re sent home to struggle because they felt they had no choice. I’m not suggesting that anyone should be wasting time in hospital beds ifvtherecready to go, but being bullied out is another thing all together. I have no intention on leaving hospital with 24hrs of major surgery and will have no appropriate care at home until the next day, I left you know my experience. I’m 5 months pregnant and feel like I’m preparing to go into battle when I’m admitted!